49
5.2 Serum Uric Acid (UA) Simple But a Long Neglected
Biomarker
Compared with other “novel” serum markers, the influence of exercise on serum
uric acid has not attracted enough attention for a long time. Montoye et al. study
based on a total of 4535 both genders, age range10–64 year’s people. They found
the serum uric acid is one of the good indicators which associated with one’s physi-
cal fitness and is much correlated to body fatness than the response of heart rate on
exercise [ 54 , 55 ]. A similar result was observed in another race/Etcitty population.
The authors selected categorized walking steps and the time per day as primary
outcomes [ 56 , 57 ]. These results are consistent with that serum uric acid may
increase during conditions of high energy utilization. Additionally, our unpublished
data based on an average 2.5 years follow-up data from a multi-center, large sample
size cohort, also indicated that serum uric acid was associated with 1.40 (1.16–1.45)
fold higher risk for adverse cardiac events even after additional adjustment for LDL,
HDL, TG, Creatinine, BMI, and hypertension.
5.3 How About Bioimaging?
Traditionally, the physical activity always associates with bone structure and bone
density change. Indeed. The bone mineral density (BMD) is evaluated by dual-
energy X-ray absorptiometry (DXA) of lumbar spine and hip, with the use of other
tests to assess atherosclerosis, when appropriate. This screening model adds consid-
erable cost and patient burden but also radiation exposure. Additional, the sensitiv-
ity of two-dimensional (2-D) DXA techniques to accurately determine early bone
loss is limited due to the natural overlapping formation of cortical and trabecular
bone. Notably, trabecular bone (the metabolically active portion) is lost first and is
the first to respond to medical therapies, making it a more realistic reflection of bone
mineral metabolism and bone density status compared to cortical bone [ 58 – 60 ]. To
date, the next-generation computed tomography (CT) scanner, MRI [ 61 ], particular
cardiac CT scan provides better cardiac imaging [ 62 – 64 ], as well as vertebral bone
mineral density information with minimal radiation, 92 of 2352 Olympic athletes,
showed abnormal CV structure and arrhythmias [ 65 ]. Given bone density status and
atherosclerosis, independent but highly interactive, we are cautiously optimistic that
bioimaging marker (both quantitative and qualitative) gathered from next- generation
CT scan has a potential to become a robust tool for exercise benefits evaluation. In
fact, compared to DXA, cardiac CT, especially the latest generation CT, allows for
a high-resolution three-dimensional (3-D) imaging by isolation of trabecular from
cortical bone of the vertebral shell and posterior elements to assess true volumetric
density, as well as cardiovascular function [ 66 – 68 ].
3 The Effects of Exercise on Cardiovascular Biomarkers: New Insights, Recent Data...